Does manual therapy improve pain, disability, and glenohumeral motion in overhead athletes? Systematic review and meta-analysis

Autor(es)

Santana, Savio Douglas Ferreira ; Gava, Vander ; de Oliveira, Valeria Mayaly Alves ; dos Santos, Gabriel Alves ; Lima, Tassio Augusto Soares ; Kamonseki, Danilo Harudy

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF OSTEOPATHIC MEDICINE; v. 55, p. 13-pg., 2025-03-01.

Resumo

Objectives: To systematically review the effects of manual therapy (MT) on pain intensity, disability, internal rotation (IR), external rotation (ER), and horizontal adduction (HA) range of motion (ROM) in overhead athletes. Data sources: Databases (Medline, EMBASE, SPORTDiscus, CINAHL, CENTRAL, Web of Science, and SCOPUS) were searched from inception up to May 2023. Study selection: Randomized controlled trials (RCTs) comparing MT to a non-treatment group or other treatment groups were selected. Data extraction: Two reviewers independently selected RCTs that investigated the effects of MT on pain intensity, disability, IR, ER, and HA ROM. Data synthesis: Mean difference or Standardized Mean Differences, along with 95 % confidence intervals, were calculated for the meta-analysis of each outcome of interest. The level of evidence was synthesized using GRADE. Results: Twelve RCTs were included, with a pooled sample of 401 athletes. MT was not superior (p > 0.05) to no treatment in improving pain, disability, IR ROM, and ER ROM, but it was superior to no treatments in improving HA. MT was not superior (p > 0.05) to other treatments in improving ER ROM and HA ROM, but it was superior other treatments in improving IR ROM and disability. Those findings were based on very low certainty of evidence. Conclusion: MT may not effectively improve pain and ER ROM. The very low quality of evidence, conflicting findings regarding the effects of MT on disability and IR, and the small, likely clinically irrelevant effects on HA, do not provide sufficient support for a definitive recommendation regarding the effectiveness of MT for treating overhead athletes. (AU)

• Processo FAPESP: 20/01449-5 - Intervenção com ferramenta via web para indivíduos com dor no ombro: ensaio controlado aleatorizado
• Beneficiário: Vander Gava
• Modalidade de apoio: Bolsas no Brasil - Doutorado Direto